CN101568360A

CN101568360A - Endotracheal intubation device

Info

Publication number: CN101568360A
Application number: CNA2007800407800A
Authority: CN
Inventors: J·施瓦茨; R·施瓦茨
Original assignee: Al Medical Devices Inc
Current assignee: Al Medical Devices Inc
Priority date: 2006-09-01
Filing date: 2007-08-24
Publication date: 2009-10-28
Also published as: KR20090049088A; JP2010502277A; US20080058599A1; CA2661868A1; WO2008030349A2; US7458375B2; EP2066377A4; WO2008030349A8; EP2066377A2; WO2008030349A3

Abstract

A device for facilitating fluid delivery to the trachea of a patient which comprises, a tubular housing adapted to be sealably mounted on an elongate element of an endoscope for examining the trachea of the patient and configured to mount an adapter for an endotracheal tube for intubating the patient over and around the elongate element, the housing having at least one inlet into a cavity inside the housing for supplying at least a first fluid and an outlet for delivering the first fluid between the elongate element and an inside wall of the endotracheal tube mounted on the adapter.

Description

Endotracheal intubation device

The cross reference of relevant patent

[0001] inapplicable

With Federal funds research or the relevant statement of development

[0002] inapplicable

Technical field

[0003] the present invention relates generally to endotracheal intubation device, and relates more specifically to a kind of trachea equipment with the flexible portion that comprises the recess that is arranged in tube element.

Background of invention

[0004] U.S. Patent No. 2,975,785 of authorizing Sheldon discloses a kind of optical observation instrument, comprises endoscope sheath and a plurality of tube elements that is provided with end-to-end relation.One end of sheath is fastened on the control chamber, and its inner is connected with the case inner room.Control chamber is used to support the various control structures that are used for endoscope, comprises being fastened to the cable of end on the tube elements, and the other end of cable is fastening and around being positioned at indoor a pair of pulley.Pulley rotates by control handle, so that the latter end bending of endoscope.The optical system of this instrument has the flexible and transparent glass fiber bundle of optical alignment.Transparent glass fibre sends the object light that a pair of lamp illuminated that freely is positioned at the instrument end, so that can see the image of object on eyepiece.

[0005] authorizes Bazinet (U.S. Patent No. 3,162,214), people's (U.S. Patent No. 4 such as Takahashi, 236,509) and Petruzzi (U.S. Patent No. 4,669,172) U.S. Patent Publication the flexible tubular structure of forming by the line of coiling and/or the annulus element that hitches, these lines and annulus element provide the flexibility of tubular structure.Petruzzi discloses a kind of method that is used to make flexible shaft, and this flexible shaft comprises the helical cutting parts with essentially identical inside diameter and the linear section of convergent shape.

[0006] U.S. Patent No. 4,861,153 of authorizing Berci discloses a kind of intubate video-endoscope, and it comprises the sheath component of elongation, and this sheath component has the controlled flexible section of selectivity, and it accommodates optical imaging system.Be generally inflexible section and comprise control chamber.Image transmits optical system and extends through the whole length of sheath component, and ends near the imaging system.Light conveying system also extends through the whole length of sheath component and arrives imaging optical system, and its rear end is suitable for being operably connected on the light source.

[0007] U.S. Patent No. 4,949,716 of authorizing Chenoweth discloses a kind of hand-held medical equipment, and its nasal cavity with wide region is settled the formula airway, so that better airway control to be provided.The flexible hose that holds leaf spring has litzendraht wire, and it stands to spur the bending of controlling airway.

[0008] authorizes people's such as Schwartz U.S. Patent No. 6,539,942 have described a kind of endotracheal intubation device, it has along the butt circular element of a series of interconnection of the distal portions setting of pipe, and the handle that is used for control appliance far-end degree of crook, this patent is attached to herein by reference and intactly.Imaging device, for example nasopharyngeal endoscope can insert and pass catheterization equipment, so that manifest patient's vocal cords during the intubate program.This endotracheal intubation device uses a kind of not rollered scissor mechanism, uses so that the device far end bending.

[0009] authorizes the U.S. Patent No. 4,905,666 of Fukuda, the U.S. Patent No. 5 of authorizing Chikama, 520,222, and the JP5 that authorizes Ogino, 329,095 have proposed bending apparatus, and it uses pulley or chain drive formula winding mechanism by crank and knob control.

[0010] U.S. Patent No. 5,327,881 of authorizing Greene discloses a kind of cannula-assisted equipment, and it has the elongated stylet that is suitable for being installed in the standard endotracheal tube.The flexible bellow zone is arranged near the near-end of elongated stylet.Flexible optical fibre and lighting fiber and stylet are set together, so that operator can carry out direct observation during the intubate process.

[0011] although related art teachings endotracheal intubation device, still exist to a kind of have flexible part and optionally interior optics so that help the demand of equipment in the intravital improvement type trachea of patient that endotracheal tube is inserted.

Summary of the invention

[0012] therefore, one object of the present invention is to provide a kind of improved endotracheal intubation device with flexible portion

[0013] passes through the following description of reference distinct these purposes and other purpose gradually.

[0014] the invention provides a kind of equipment of being convenient to the patient is carried out endotracheal intubation, comprising: grip device; Tube element, it has far-end and is attached to near-end on the grip device; Be arranged near the flexible part of the tube element the tube element far-end, it has and is arranged in one or more recesses that tube element is suitable for making flexible part bending; Be arranged on the grip device or near the control device it; And the device that is used for moving flexible part, it transmits by user and is applied to power on the control device so that flexible part bending, wherein, when flexible part is operated by user at control section, bend to the configuration of general curved in a controlled manner from complete straight configuration, the form of when control device is subjected to discharging, then getting back to less bending.

[0015] in other embodiments, tube element is made of rustless steel or marmem (SMA).In other other embodiment, tube element is made of Nitinol.In other other embodiment, recess is arranged to be arranged in the otch of flexible part.In other embodiments, recess is arranged to be arranged in the wedge shape grooving of flexible part.In other other embodiment, this equipment also comprises and is blown into adnexa, comes from the secretions in the patient airway and supplies with oxygenation in order to removing.In other other embodiment, the device that is used for mobile flexible part is the line that is attached on the control device.In other other embodiment, wherein control device is the trigger piece that is installed on the grip device.In other other embodiment, this equipment also comprises the display device that is positioned on the equipment near-end, shows the image of patient's throat when being used for during the endotracheal intubation program far-end of reach tube element.

[0016] the invention provides and a kind of endotracheal tube is inserted the method for patient's trachea, comprising: a kind of equipment is provided, and it comprises: grip device; Have the near-end that is attached on the grip device and the tube element of far-end; Be arranged near the flexible part of the tube element the tube element far-end, it has and is arranged in one or more recesses that tube element is suitable for making flexible part bending; Be arranged on the grip device or near the control device it; And the device that is used for moving flexible part, it transmits by user and is applied to power on the control device so that flexible part bending, wherein, when flexible part is operated by user at control section, bend to the configuration of general curved in a controlled manner from complete straight configuration, the form of when release control device, then getting back to less bending; Endotracheal tube is slipped on the tube element of equipment; The far-end that will have the tube element of endotracheal tube inserts in patient's mouth; Operating control device is enough to make the far-end of tube element to advance in patient's throat safely so that flexible part bends to; The far-end of tube element is advanced, endotracheal tube is placed patient's trachea; And tube element removed from patient's mouth.

[0017] in other embodiments, tube element is made of rustless steel or marmem (SMA).In other other embodiment, tube element is made of Nitinol.In other other embodiment, recess is set to be arranged in the otch of flexible part.In other embodiments, recess is set to be arranged in the wedge shape grooving of flexible part.In other other embodiment, the device that is used for mobile flexible part is the line that is attached on the control device.In other other embodiment, control device is the trigger piece that is installed on the grip device.In other other embodiment, by squeezing operating control device.

[0018] the invention provides and a kind of endotracheal tube is inserted the method for patient's trachea, comprising: a kind of equipment is provided, and it comprises: grip device; Have the near-end that is attached on the grip device and the tube element of far-end; Be arranged near the flexible part of the tube element the tube element far-end, it has and is arranged in one or more recesses that tube element is suitable for making flexible part bending; Be arranged on the grip device or near the control device it; And the device that is used for moving flexible part, it transmits by user and is applied to power on the control device so that flexible part bending, wherein, when flexible part is operated by user at control section, bend to the configuration of general curved in a controlled manner from complete straight configuration, when control device obtains discharging, then get back to the configuration of less bending; Endotracheal tube is slipped on the tube element of equipment; The far-end that will have the tube element of endotracheal tube inserts in patient's mouth; The image of the patient throat of observation in display device; Operating control device is enough to make the far-end of tube element to advance in patient's throat safely so that flexible part bends to; The far-end of tube element is advanced, endotracheal tube is placed patient's trachea; And tube element removed from patient's mouth.

[0019] in other other embodiment, tube element is made of rustless steel or marmem (SMA).In other other embodiment, tube element is made of Nitinol.In other other embodiment, recess is arranged to be arranged in the otch of flexible part.In other embodiments, recess is set to be arranged in the wedge shape grooving of flexible part.In other other embodiment, the device that is used for mobile flexible part is the line that is attached on the control device.In other other embodiment, control device is the trigger piece that is installed on the grip device.In other other embodiment, control device is operated by squeezing.

Description of drawings

[0020] Fig. 1 shows according to endotracheal intubation device 10 of the present invention environmental perspective view in use.

[0021] Fig. 2 shows the environmental perspective view of endotracheal intubation device 10 before using of inserting endotracheal tube E.

[0022] Fig. 3 shows the side sectional view of the endotracheal intubation device 10 that capping 135 removed.

[0023] Fig. 3 A is the sectional view of endotracheal tube retainer 75.

[0024] Fig. 3 B shows the environmental perspective view with the endotracheal intubation device 10 that sucks adnexa 301.

[0025] Fig. 3 C is the sectional view with the endotracheal tube retainer 75 that sucks adnexa 301.

[0026] Fig. 3 D be have suction adnexa 301 with fluid port 320 ' the sectional view of endotracheal tube retainer 75 of another embodiment.

[0027] Fig. 4 shows the distal end view of the tube element 40 that is intercepted along the line 4-4 of Fig. 3.

[0028] Fig. 5 shows the sectional view of the endotracheal intubation device 10 that is intercepted along the line 5-5 of Fig. 2.

[0029] Fig. 6 shows the zoomed-in view of first embodiment of the flexible part 70 of the tube element 40 among the Fig. 5 with wedge shape grooving 423.For clarity sake, Fig. 6 A shows first embodiment of the flexible part 70 that does not have internals.

[0030] Fig. 6 B show the flexible part 70 of the tube element 40 among the have grooving Fig. 5 of (411,412) ' the zoomed-in view of second embodiment.

[0031] Fig. 6 C show the flexible part 70 that intercepted along the line 6C-6C of Fig. 6 B ' the end-view of second embodiment.

[0032] Fig. 7 shows the top cross-sectional view of the endotracheal intubation device 10 that is intercepted along the line 7-7 of Fig. 3.

[0033] Fig. 8 shows the partial section of the endotracheal intubation device 10 that is intercepted along the line 3-3 of Fig. 2.

[0034] Fig. 8 A shows the amplification sectional view of the handle among Fig. 5.

[0035] Fig. 9 shows the perspective view of the york piece part 155 of equipment 10.

[0036] Figure 10 shows the perspective view of the alternative of the endotracheal intubation device 110 that has video system according to the present invention.

The specific embodiment

[0037] all patents, patent application, government publication, government regulation and the documents and materials of being quoted in this description all are attached to herein by reference and intactly.If conflict will be as the criterion with this description that includes definition to some extent.

[0038] as used herein term " near-end " is meant when using endotracheal intubation device the direction towards medical professional.

[0039] as used herein term " far-end " is meant when using endotracheal intubation device the direction towards the patient of pending endotracheal intubation.

[0040] as used herein term " top " or " top " refer to respectively and a corresponding device orientation in handle top side or a side.

[0041] as used herein term " below " or " bottom " refer to respectively and a corresponding device orientation in handle bottom side or a side.

[0042] as used herein term " left side " is meant the side with the corresponding equipment in left side of handle.

[0043] as used herein term " right side " is meant the side with the corresponding equipment in right side of handle.

[0044] as used herein term " control device " be meant well known in the art can be by user operation any mechanism with the bending of controlling flexible part.An example of control device is a trigger piece as described herein.This term also comprises the mechanism such as button, knob, wheel shape thing etc., and it can be squeezed, rotate, be pushed by user or other operation.

[0045] as used herein term " bendable apparatus " is meant the flexible part of tube element.In certain embodiments, as in two alternatives as herein described, the part of (for example otch, wedge mouth etc.) that the bendable portion branch is arranged to have grooving.

[0046] as used herein term " is used for moving the device of flexible part " and comprises any mechanism that the conversion of motion of control device can be become the motion of flexible part, comprises mechanical mechanism or motor machine mechanism.This term comprises the mechanism such as control line, but is not limited thereto.

[0047] as used herein term " display device " is meant during carrying out the endotracheal intubation program, is used to be presented at any mechanism or the device of image of patient's throat of tube element far-end.An example of display device includes but not limited to video display units or one or more lens of liquid crystal display or other type, and it gathers image from fiber optics system.

[0048] be meant can be by the user grasping to hold any handle of endotracheal intubation device, such as but not limited to gun type handle as herein described for as used herein term " grip device ".

[0049] as used herein term " suction " is meant the air flue that gas, liquid or dusty material is blown into the patient.

[0050] as used herein term " pulley gear " is meant and comprises one or more pulleys, is used for well known in the art any device of translates force.

[0051] as used herein term " recess " is the broad sense term that comprises any breach, breach or the grooving that are arranged in tube element." grooving " that this term comprised comprises and is arranged in tube element as the narrow grooving of " otch " and V-arrangement grooving as the broad of " wedge mouth "." otch " of being arranged to narrow grooving preferably is arranged on the opposite side of flexible part.

[0052] as used herein term " SMA " is the abbreviation that is also referred to as the marmem of memory metal or smart wire.Some examples of SMA include but not limited to copper-Zn-Al alloy, copper-aluminum-nickel alloy, and Ni-Ti (NiTi) alloy such as Nitinol (Nitinol of naval ordnance laboratory development).

[0053] as used herein term " tube element " is meant elongated parts, includes but not limited to tube element as herein described.Tube element can be cylindrical, but it is not limited thereto.Any elongated shape that endotracheal tube can slip over is all comprised by the present invention.

[0054] as used herein term " transmitting device " is meant and is used for the image of throat is transferred to any mechanism or device in the display device from finder.An example of transmitting device includes but not limited to conductor wire, optical fiber cable and/or optical lens.

[0055] as used herein term " finder " is meant any mechanism or the device that is used for during carrying out the endotracheal intubation program at the image of tube element far-end collection patient throat.An example of finder includes but not limited to miniature camera or is used for the lens of fiber optics system.

[0056] authorize people's such as Schwartz U.S. Patent application No.11/230,392 have described a kind of endotracheal intubation device, and this patent application is attached to herein by reference and intactly.The present invention is the evolutionary approach of this equipment.The invention provides a kind of equipment of being convenient to the patient is carried out endotracheal intubation, comprising: (a) grip device; (b) have the near-end that is attached on the grip device, and the tube element of far-end; (c) be arranged near the flexible part of the tube element the tube element far-end, it has and is arranged in one or more recesses that tube element is suitable for making flexible part bending; (d) be arranged on the grip device or near the control device it; And the device that (e) is used for moving flexible part, it transmits by user and is applied to power on the control device so that flexible part bending, wherein, when flexible part is operated by user at control section, bend to the configuration of general curved in a controlled manner from complete straight configuration, the form of when decontroling control device, then getting back to less bending.

[0057] among Fig. 1 to Fig. 9 one embodiment of the present of invention has been shown.This embodiment of endotracheal intubation device 10 in use has been shown among Fig. 1 and Fig. 2.Fig. 1 shows medical professional M and how the tube element 40 of endotracheal intubation device 10 is inserted in the body of patient P.Endotracheal intubation device 10 is by medical professional M grasping on handle 20, and this handle has top 20A, bottom 20B, left side 20C, right side 20D (see figure 7), anterior 20E and rear portion 20F.The finger grip of medical professional is pivotably mounted on the trigger piece 30 on the handle 20.Trigger piece 30 has first end 31 that is used at medical professional M controlled motion when handle 20 squeezes trigger piece 30.As shown in Figure 8, when the medical professional squeezes first end 31 of trigger piece 30, bend to the configuration of general curved in a controlled manner from complete straight configuration towards the flexible part 70 (Fig. 1, Fig. 2, Fig. 3, Fig. 5, Fig. 6, Fig. 7 and Fig. 8) of tube element 40 far-ends.Medical professional thereby the far-end 47 of tube element 40 is moved is so that tube element 40 advances in patient's the throat safely.Endotracheal intubation device 10 is subjected to good sealing, so that body fluid can not infilter equipment 10 and any internals of infringement.

[0058] Fig. 2 showed before 10 couples of patients of use equipment carry out endotracheal intubation, how on the tube element 40 of endotracheal intubation device 10 endotracheal tube E to be inserted retainer 75 (Fig. 1, Fig. 2 and Fig. 3 A).Tube element 40 locates to be attached at the anterior 20E place of handle 20 at the near-end 42 (Fig. 2, Fig. 3, Fig. 5, Fig. 8 and Fig. 8 A) of the portions of proximal 41 (Fig. 2) of tube element 40, and extend to the far-end 47 of distal part 45 (Fig. 2), this far-end inserts in patient's the throat, so that endotracheal tube E is placed in patient's body.Pivotable opticator 80 is attached to (see figure 3) in the eyepiece change 84 on the handle 20 rear portion 20F at far-end 83 places of opticator 80.Eyepiece assembly 88 is outstanding from the near-end 85 (Fig. 5) of eyepiece change 84.Locating at the near-end 82 (Fig. 3) of opticator is eyepiece shell 92, and it is installed on the near-end 89 of eyepiece assembly 88.Medical professional M can watch in the near-end 82 of opticator 80, marches to the image of observing patient's throat when endotracheal tube E placed the trachea of patient P with the far-end at tube element 40.Because endotracheal intubation device 10 is combined with interior optics, so it can be used for being difficult for using the situation of the outside imaging device such as nasopharyngeal endoscope.

[0059] Fig. 3 to Fig. 9 at length shows the internal work situation of endotracheal intubation device 10.As shown in Figure 5, handle 20 provides the shell 101 with inwall 102, and inwall 102 defines the illumination cavity 103 towards equipment 10 bottoms.Illumination cavity 103 has been sealed by pyrite or other can lead the columniform Battery shell 105 that material constitutes, and it has top 105A and bottom 105B.Battery shell 105 (Fig. 5) is arranged to the inwall 102 against shell 101, towards the bottom of handle 20 20B.Two battery 120A, 120B in series is arranged in the Battery shell 105, is arranged in the illumination cavity 103 of handle 20.These two battery 120A, 120B remains in the illumination cavity 103 by battery plug 114, and this battery plug 114 is installed in this two battery 120A, and the below of 120B is positioned at the bottom 20B of handle 20.Battery plug 114 has the 114A of first, is inserting these two battery 120A, when inserting battery plug 114 in the illumination cavity 103 after the 120B, can grasp the 114A of first.When inserting battery plug 114, the O shape of battery plug ring 116 holds the second portion 114B that is positioned at battery plug 114 centers, and is resisted against closely on the inwall 102 of handle 20 shells 101.Battery plug 114 has threaded 115 third part 114C, and it is screwed into the threaded portion 104 in illumination cavity 103 inwalls 102.Because against inwall 102 assemblings, so work as equipment 10 in use, battery plug 114 can not unclamp the O shape of battery plug ring 116 closely.The O shape ring 116 of battery plug also remains on fluid outside the equipment 10.

[0060] contact cap 119 is enclosed in the depressed area among the second portion 114C of battery plug 114.When being screwed into battery plug 114 in the handle 20, the spring 117 that is arranged on projection 118 tops in the contact cap 119 is held against the negative terminal of the first battery 120A, to form electrical contact and with two battery 120A, 120B is bearing in the illumination cavity 103.Lampshade 106 (Fig. 5) in illumination cavity 103 above the top of handle 20 20A is enclosed in Battery shell 105.In lampshade 106 is lamp 107, and it is the light source that is used for endotracheal intubation device 10.Lamp 107 can be xenon lamp or other similar light source.Lamp 107 is fixed on the first end 108A of lamp socket 108.Lampshade 106 holds the first end 108A of lamp socket 108 with sealed light 107.The second end 108B of lamp socket 108 is shelved among the top 105A of Battery shell 105.First electrical contact 109 that is held by insulator ring 112 is positioned at the second end 108B place of lamp socket 108.Insulator ring 112 is fastened on lamp socket 108 in the Battery shell 105, also isolates the electric connection of first contact 109 and Battery shell 105 simultaneously.Second contact 110 on the lamp socket 108 extends above insulator ring 112, and electrically contacts with Battery shell 105.

[0061] as shown in Fig. 5 and Fig. 8 A, fiber ferrule 121 from the top towards the top of handle 20 20A and anterior 20E and the near-end that penetrates 106, three illuminated fibres 122 of lampshade (Fig. 8 A) be fastened in the fiber ferrule 121.Illuminated fibres 122 (Fig. 8 A) remains closely adjacent lamp 107 (Fig. 5) by fiber ferrule 121, and by two battery 120A, during the 120B power supply, illuminated fibres 122 can be gathered the light from lamp 107 with convenient lamp 107.In use, can so that battery plug 114 is advanced in the illumination cavity 103, electrically contact with the bottom 105B of battery cartridge 105, thereby lamp 107 is started by rotation battery plug 114 (Fig. 5) up to contact cap 119.Circuit has been connected in this action, so that to lamp 107 power supplies.When obtaining power supply, lamp 107 is gathered light by the near-end of three illuminated fibres 122 herein with light emission (Fig. 8 A) in the first end 121A of fiber ferrule 121.The second end 121B (Fig. 8 A) of fiber ferrule 121 is outstanding and enter the connection chamber 130 that inwall 102 and left side capping 135 (Fig. 7) by right side shell 101 limited (Fig. 3, Fig. 5, Fig. 8 and Fig. 8 A) from lampshade 106.Connection chamber 130 extends into the lever chamber 150 (Fig. 3, Fig. 5, Fig. 8 and Fig. 8 A) that is arranged in illumination cavity 103 tops and far-end from illumination cavity 103.In shell 101, what be close to lamp 107 is transparency window 21, as seen in Figure 2.Transparency window 21 is installed in the opening that penetrates the lampshade 106 on handle 20 left side 20C and the lamp 107.When lamp 107 is opened, illuminated transparency window 21 as the power connection attention device.

[0062] lever chamber 150 is sealed by shell 101 on the right side, and is sealed by capping 135 (Fig. 7) in the left side.Capping 135 (Fig. 2 and Fig. 3) is attached on the shell 101 by the anterior screw 136 (Fig. 2 and Fig. 3) at capping 135 anterior places and the left pivot screw 98 (Fig. 2) at place, capping 135 rear portions.As mentioned before, be installed in the trigger piece 30 on the handle 20, it has first end 31, is used for the flexibility in the flexible part 70 of control valve linear element 40 when handle 20 squeezes trigger piece 30.As shown in Figure 7, first end 31 (Fig. 2) of trigger piece 30 is installed on the pivot section 33 of second end 32 (Fig. 3) of trigger piece 30, this trigger piece 30 is installed in the shell 101, is positioned at the intersection in connection chamber 130 (Fig. 3, Fig. 5, Fig. 7, Fig. 8 and Fig. 8 A) and lever chamber 150 (Fig. 3, Fig. 5, Fig. 8 and Fig. 8 A).As seen in Figure 7, handle 20 is crossed in pivot section 33 horizontal expansion from left to right of trigger piece 30.Pivot section 33 extends to right erection column 35 from left erection column 34, left side erection column 34 is rotatably installed in the left installing hole 137 of the capping that is arranged in handle 20 left sides, and right erection column 35 is rotatably installed in the right installing hole 23 of the inwall that is arranged in handle 20 right side 20D.As seen in Figure 7, pivot O shape ring 36 is assemblied between the pivot section 33 around left erection column 34, and is shelved in the groove 138 that holds left installing hole 137.Hinge part 31A on trigger piece 30 first ends 31 is installed in the trigger piece installing hole 139 in the capping 135, and hinge part 31A extends through capping 135 and arrives left installing hole 137.Trigger piece pivot pin 140 pass trigger piece 30 first end 31 hinge part 31A and penetrate first pivot pin hole 141, and penetrate the second pivot pin hole 34A in the left erection column 34 of pivot section 33, be fastened on the pivot section 33 with first end 31 trigger piece 30.Seen in Fig. 8 A, the elongated york piece part 155 of second end 32 of trigger piece 30 extends to above pivot section 33 in the lever chamber 150 of handle 20.Between pivot section 33 and york piece part 155, pivot passage 37 extends through second end 32 of trigger piece 30 from front to back, and this pivot passage 37 provides the path between illumination cavity 103 and lever chamber 150.

[0063] as shown in Fig. 8 A, passage 160 (Fig. 5, Fig. 8 and Fig. 8 A) is installed is passed the shell 101 of handle 20 and capping 135 (Fig. 7) and extend certain length.Installation passage 160 extends to the bottom in lever chamber 150 from the front side of handle 20, the pivot passage 37 in contiguous trigger piece 30 second ends 32.Tubulose installation shaft 161 is mounted to concordant with the wall that limits installation passage 160 and extension installation passage 160 length.Installation shaft 161 is anchored in the handle 20 by center wheel rim 162 (Fig. 8 and Fig. 8 A), center wheel rim 162 is around the fluting 142 (Fig. 7) in groove 24 in the installation shaft 161 and the handle 20 of packing into (Fig. 1, Fig. 8 and Fig. 8 A) and the capping 135, with blocked center wheel rim 162.The near-end 42 of the portions of proximal 41 of tube element 40 (Fig. 8 A) has the internal diameter that makes in its tubulose installation shaft 161 of closely packing into.Tube element 40 extends through the length of installation shaft 161, so that tube element 40 is fastened on the handle 20.

[0064] externally, the portions of proximal 41 of the adjustable endotracheal tube retainer 75 surrounding tube linear elements 40 as shown in Fig. 3 and Fig. 3 A.The first end 75A (Fig. 3 A) of endotracheal tube retainer 75 has the first circular open 75C, and the diameter of opening 75C is suitable for holding the end of the standard adapter 77 on the endotracheal tube E as shown in Fig. 3 A.Endotracheal tube retainer 75 is clamped in standard adapter 77 among the first opening 75C at endotracheal tube end place, so that make it will can slippage during the intubate program.The second opening 75D is positioned at the second end 75B of endotracheal tube retainer 75, has the diameter that is assemblied on the tube element 40.Endotracheal tube retainer 75 is fastened on the correct position of portions of proximal 41 by limit screw 76.

[0065], as shown in Fig. 3 B, Fig. 3 C and Fig. 3 D, is blown into adnexa (301,301 ') and can be inserted between standard adapter 77 and the endotracheal tube retainer 75 as alternative.Wide (302,302 ') being blown into adnexa (301,301 ') have chamber (303,303 '), and standard adapter 77 is enclosed in this chamber (303,303 ').The place, opposite end that is blown into adnexa (301,301 '), narrow (304,304 ') portion (302 leniently, 302 ') outstanding, have the external diameter of the first opening 75C that is enclosed in the first end 75A place that is arranged in endotracheal tube retainer 75, and be assemblied in the internal diameter on the tube element 40.In certain embodiments, it is disposable being blown into adnexa (301,301 ').Be blown into adnexa (301,301 ') can be hooked into by port (305,305 ') and on the localized source of oxygen pipeline, this port passes wide (302,302 ') and enter chamber (303,303 '), thereby to allow that oxygen flows into and passes endotracheal tube E removing and comes from the secretions of patient airway and oxygenation is provided.Optionally, be blown into adnexa 301 ' an embodiment in, shown in Fig. 3 D, also can increase fluid port 320, to allow the injection local anesthetic.Medicine, for example amino ester such as lignocaine or amino amides local anesthetic, it can give via fluid port 320, so that make it downwards by endotracheal tube E and enter in patient's body.In certain embodiments, fluid port 320 is arranged to revolve the lock adnexa, so as the syringe (not shown) can easily to be attached to be blown into adnexa 301 ' on.Removable medicated cap 321 is arranged in order to seal fluid port 320 when not using.

[0066] length of the inner passage in tube element 40 44 (Fig. 8 A) extension linear element 40, portions of proximal 41, the flexible part 70 (Fig. 1, Fig. 2, Fig. 3, Fig. 5, Fig. 6, Fig. 7 and Fig. 8) of passing tube element 40 from the near-end 42 that leads near the lever chamber 150 the pivot passage 37, and pass distal part 45 and the far-end 47 (Fig. 6) of arrival tube element 40, herein, the inner passage that distally head 48 is inserted with capping far-end 47 places.Article three, illuminated fibres 122 (Fig. 8 A) sends the light from lamp 107, in the fiber ferrule 121 near the lampshade 106 of the light collected lamp 107 of near-end.Article three, illuminated fibres 122 extends through connection chamber 130, pivot passage 37, lever chamber 150, and enter the near-end 42 of inner passage 44, herein, they extend on the far-end 47 of distal part 45 of tube element 40, and pass distally head 48, at these head 48 places, they end at far-end 122B as shown in Figure 4,123B, the 124B place.When rotation battery plug 114 to connect circuit and be lamp 107 when powering, from the far-end 122B of three illuminated fibres 122,123B, the illumination of 124B is bright patient's throat.

[0067] as the best viewed among Fig. 6, in the far-end 47 of the distal part 45 of distally head 48 insertion tube linear elements 40.Pipe 56 (Fig. 6) extend from distally head 48 in distal part 45, with first end 52 of supporting optical fiber 50.As shown in Figure 4, the lens 57 that are used for optical fiber 50 are positioned at the far-end 122B of three illuminated fibres 122, and 123B is between the 124B.In one embodiment, the lens in the perforate 57 have about 60 ° visual field.The lens 57 (Fig. 4, Fig. 5 and Fig. 6) of optical fiber 50 from first end 52 (Fig. 5 and Fig. 6) that is positioned at optical fiber 50 extend, and pass the length of inner passage 44 (Fig. 5, Fig. 6 and Fig. 8 A) and arrive second end 53 (Fig. 5 and Fig. 7) at place, handle 20 rear portions.Optical fiber 50 extends into lever chamber 150 (Fig. 3, Fig. 5 and Fig. 8 A) from the inner passage 44 (Fig. 5, Fig. 6 and Fig. 8 A) of tube element 40, pass pivot passage 37 (Fig. 5, Fig. 7, Fig. 8, Fig. 8 A and Fig. 9), go forward side by side into optics passage 170 (Fig. 3, Fig. 5, Fig. 7, Fig. 8 and Fig. 8 A), it penetrates shell 101, and through to the rear portion of handle 20.Optical fiber 50 enters inner passage 87 (Fig. 5) from the rear portion of handle 20, and the eyepiece change 84 (Fig. 3 and Fig. 5) that is positioned at opticator 80 far-ends 83 places is passed in inner passage 87.Second end 53 (Fig. 5) of optical fiber 50 passes the inner passage 87 of eyepiece change 84, and ends at near-end 85 places (Fig. 3 and Fig. 5) of eyepiece change 84.Alternative of the present invention has been shown among Figure 10, and it is identical with the embodiment of Fig. 1 to Fig. 9 except that optical system.In this embodiment, the miniature camera 220 that is positioned at far-end 230 places of equipment 210 is connected on the miniature video display 240 of the equipment of being positioned at 210 proximal ends via lead.In certain embodiments, during the endotracheal intubation process, when the far-end of tube element moves forward, can observe the miniature video display in the equipment near-end by the opening in the eyepiece shell.

[0068] as shown in Fig. 2 and Fig. 5, eyepiece assembly 88 is attached on the near-end 85 (Fig. 5) of eyepiece change 84 (Fig. 5), has from eyepiece change 84 (Fig. 5) to extend to inner passage 91 (Fig. 5) on the near-end 89 of eyepiece assembly 88.The far-end 94 (Fig. 2 and Fig. 5) of the Ortho eyepiece shell 92 (Fig. 2, Fig. 3 and Fig. 5) of 18mm is screwed on the eyepiece assembly 88, makes the near-end 89 of eyepiece assembly 88 lean against on the lock ring 95 in the eyepiece shell 92 (Fig. 5) (Fig. 5).The near-end 93 of eyepiece shell 92 (Fig. 3 and Fig. 5) outwards opens, so that the rounded lip as the eyes bearing to be provided.Opening 96 (Fig. 5) is positioned at the near-end 93 of eyepiece shell 92, is positioned at the center of eyepiece shell 92 recesses 91 (Fig. 5).Opticator 80 is by a series of lens 175,176,177 (Fig. 5), makes the light that is collected locate to focus at the lens 57 (Fig. 4 and Fig. 6) of optical fiber 50, and these only send from second end 53 of optical fiber 50.During the endotracheal intubation program, when the far-end 47 of tube element 40 moves forward, can observe the image of patient's throats by the opening in the eyepiece shell 92 96.

[0069] as shown in Figure 5, second end 53 of optical fiber 50 is enclosed in the flexible conduit 171 that can be made of silicone.Flexible conduit 171 is supported by the one section silicone pipeline 172A that holds flexible conduit 171 that is remained on by lock ring 173A in handle 20 rear portions at far-end.The near-end of flexible conduit 171 in a similar manner by by lock ring 173B kept one section hold the silicone pipeline 172B of flexible conduit 171 and in the inner passage 87 of eyepiece change 84, supported.The optical fiber 50 of the inner passage 87 of eyepiece change 84 is stretched out and passes in flexible conduit 171 sealings from optical channel 170, so that protect optical fiber 50 when mobile optical part 80.As seen in Figure 7, eyepiece change 84 is installed on the left pivot screw 98 in the left side, and this screw 98 penetrates capping 135 at the rear portion of handle 20 20F and left side 20C place.Eyepiece change 84 is installed on the right pivot screw 99 on the right side in a similar manner, and this screw 99 penetrates shell 101 at the rear portion of handle 20 20F and right side 20D.As shown in Figure 7, left pivot screw 98 and right pivot screw 99 do not stop up the inner passage 87 of eyepiece change 84.Therefore, although the near-end 85 that flexible conduit 171 is extended until eyepiece change 84, opticator 80 still can move up and down with respect to handle 20.Second end 53 of optical fiber 50 is covered by capping glass 174A (Fig. 5), and is kept by the support 174 that is arranged on flexible conduit 171 far-end 171A top.

[0070] optical fiber 50 is kept by support 174, so that image throws by the series of lenses 175,176,177 (Fig. 5) in eyepiece assembly 88 and the eyepiece shell 92.Distally lens 175 are installed in the distally and amplify in the chamber 180, and nearside lens 176 are installed in the nearside amplification chamber 181.The lens 175,176 that are installed in the eyepiece assembly project light on the lens 177 in the eyepiece shell 92.As shown in Figure 5, be installed in the eyepiece shell 92 forms 96A against opening 96, avoid fluid with the protection internal part by washer sealing.The lens 177 of eyepiece shell 92 are configured such that the image of patient's throat can observe by the opening in the eyepiece shell 92 96.

[0071] when the clear far-end 47 of seeing tube element 40 from the image of patient's throat must be crooked when avoiding throat structure (for example rear portion of throat), can squeeze trigger piece 30 so that 70 bendings of flexible part, thus the observation vocal cords.As among Fig. 8 A as seen, when squeezing first end 31 of trigger piece 30 towards handle 20, pivot section 33 and york piece part 155 are rotated forward, so that play the effect of lever.Extension spring 156 and is attached to (see figure 9) on the rear wall in lever chamber 150 in the second end 156B place on the first end 156A (Fig. 8 A and Fig. 9) locates to be attached to york piece part.Extension spring 156 hinders york piece parts 155 and travels forward, and when the pressure of release action on first end 31 of trigger piece 30, york piece part 155 is return once more backward.

[0072] as shown in Figure 9, the left protruding 155A of york piece part 155 and right protruding 155C extend upward, to limit the space that hollow cylinder york piece change 190 is installed on wherein.Hollow line joint 195 is installed in the cylindrical york piece change 190.A segment length that is adjacent to second end 73 of control line 71 is fastened in the wire terminal 195, so that control line 71 extends towards the rear portion of handle 20 20F from the second end 195B of wire terminal 195.Two locking nuts 199 are threaded and are locked on the external screw thread of wire terminal 195 front end 195A, and lean against on the wheel rim 193 of york piece change one end, towards the anterior 20E of handle 20.Left side york piece pin 188 penetrates the hole 155B of the left protruding 155A that passes york piece 155, passes the left hole of york piece change 190, the left hole in the wire terminal 195 of going forward side by side.Right york piece pin 189 penetrates the hole 155D of the right protruding 155C that passes york piece part 155 in a similar manner, passes the right ports of york piece change 190, the right ports in the wire terminal 195 of going forward side by side.A left side york piece pin 188 and right york piece pin 189 are allowed rotation in york piece part 155 when assembled components is worked as york piece part 155 and moved forward and backward in lever chamber 150.

[0073] pulley 25 (Fig. 3, Fig. 5, Fig. 8, Fig. 8 A and Fig. 9) that is installed on the pulley pin 26 (Fig. 3, Fig. 5, Fig. 8, Fig. 8 A and Fig. 9) has also been sealed in the shell 101 of handle 20 and capping 135, and stretch out in the right side of pulley pin 26 from be installed in shell 101 and the left side that is installed in the capping 135.Pulley 25 is enclosed in the pulley chamber 27 (Fig. 8 A) that is arranged in 150 rears, lever chamber.Control line 71 passes control line hole 152 (Fig. 8 A) in 150 rear walls 151 of lever chamber and the top of crossing the pulley 25 in the pulley chamber 27 towards second end 73.Control line 71 is wound on the bottom of pulley 25, and herein, control line 71 enters into the optical channel 170 (Fig. 8 A) below the pulley 25, and (Fig. 8 A is Fig. 9) with lever chamber 150 to extend through pivot passage 37 forward with optical fiber 50 almost parallel ground.Control line 71 extends into the inner passage 44 of tube element 40 at near-end 42 places of portions of proximal 41, and pass the inner passage 44 of tube element 40, arrive first end 72 (Fig. 6) of the control line 71 at the far-end 70B place that is positioned at flexible part 70 as seen in Figure 6.

[0074] first embodiment of flexible part 70 has been shown among Fig. 6.For clarity sake, this embodiment that does not have internals has been shown among Fig. 6 A.Illustrated among Fig. 6 B (for clarity sake having removed protection pipeline 65) flexible part 70 ' second embodiment.Remove outside the flexible part (70,70 '), the endotracheal intubation device 10 in these two embodiment all is identical.Fig. 6 A and Fig. 6 B promote clearness and the internals of not shown equipment, yet should be understood that, illuminated fibres 122, optical fiber 50, and control line 71 has passed flexible part (70,70 ').In these embodiments, flexible part (70,70 ') links to each other with the remainder of tube element 40.Randomly in pipeline, make grooving (411,412,421,422,423) by means of laser cutting device, to allow flexible part (70,70 ') bending when trigger piece is subjected to squeezing.

[0075] in the embodiment shown in Fig. 6 A, in the flexible part 70 of tube element 40, forms three groups of (421,422,423) alternative groovings.Two groups of groovings (421,422) are made for the top that is positioned at flexible part 70 and the otch on the bottom.First group of grooving 421 is positioned on the top side of flexible part 70, and second group of grooving 422 is positioned on the bottom side of flexible part 70.The 3rd group of grooving 423 of wedge (for example, " V ") shape is arranged on the top side of flexible part 70.In this embodiment, the length of flexible part 70 is 6.5 centimetres (2.56 inches), the length of portions of proximal 41 (see figure 3)s of tube element 40 is 29 centimetres (11.4 inches), and the length of the distal part 45 of tube element 40 is 2.5 centimetres (0.98 inches).In this embodiment, tube element 40 has the external diameter of 5.75 millimeters (0.226 inches).

[0076] in the embodiment shown in Fig. 6 B, two groups of alternative groovings (411,412) of making otch be arranged in tube element 40 ' flexible part 70 '.First group of grooving 411 be positioned at flexible part 70 ' the top side on, and second group of grooving 412 be positioned at flexible part 70 ' the bottom side on.In certain embodiments, first group of grooving is darker than second group of grooving.In one embodiment, first group of grooving 411 has the degree of depth α of 0.18 inch (4.57mm) and the width of 0.015 inch (0.38mm).In this embodiment, second group of grooving 412 has the degree of depth β of 0.0675 inch (1.71mm) and the width of 0.015 inch (0.38mm).In this embodiment, the grooving gap is 0.035 inch (0.89mm).In this embodiment, flexible part 70 ' length be 2.6 inches (66mm).Seen in Fig. 6 B and Fig. 6 C, the degree of depth β of the degree of depth α of first group of grooving 411 and second group of grooving 412 is overlapping, make flexible part 70 ' edge apart from flexible part 70 ' the top be that the sweep γ at distance theta place carries out bending.In certain embodiments, this distance theta is about 2/3 of tube element 40 width.

[0077] the whole length of flexible part (70,70 ') by such as

Pipeline (Du Pont; the Wilmington city; the Delaware) or the protection pipeline 65 (seen in Fig. 6 A) of other firm piping material and so on cover; the flexible part (70 of protection pipeline 65 sealings; 70 ') internals; optical fiber 50 and three illuminated fibres 122 extend through flexible part (70,70 ').Control line 71 extends near the far-end of flexible part (70,70 ') or its, is subjected to fastening (not shown) at this control line.As shown in Fig. 8 and Fig. 8 A, when squeezing first end 31 of trigger piece 30, second end 32 that is used as the trigger piece 30 of lever centers on second end 73 of pulley 25 pulling control lines 71, so that tension force is applied on the control line 71.Tension force on the control line 71 makes flexible part (70, the 70 ') bending that is in complete flat configuration in a controlled manner along sweep γ.

[0078] although tube element 40 can be made of rustless steel, polymer or other sturdy material, in certain embodiments, it is made of marmem (SMA).The Any shape memorial alloy, for example copper-Zn-Al alloy, copper-aluminum-nickel alloy, and Ni-Ti (NiTi) alloy all can use, such as but not limited to Nitinol.Tube element 40 is when being made of the marmem such as Nitinol.The marmem (SMA) of flexible part (70,70 ') will bending when trigger piece 30 is subjected to squeezing, and will get back to its original form then when trigger piece 30 is subjected to discharging, and this is that to recoil to the trend of less bending shape by SMP caused.

[0079], should know that the present invention is not limited to this although described the present invention with reference to illustrated embodiment in the literary composition.Those skilled in the art and touch personnel that this paper instructs content and will recognize that other modification and embodiment in the scope of the invention.Therefore, the present invention is only limited by claims.

Claims

1. equipment of being convenient to the patient is carried out endotracheal intubation comprises:

(a) grip device;

(b) tube element, it has far-end and is attached to near-end on the described grip device;

(c) the flexible part of described tube element, it is arranged near the far-end of described tube element, has to be arranged in one or more recesses that described tube element is suitable for making described flexible part bending;

(d) be arranged on the described grip device or near the control device it; And

(e) be used for moving the device of described flexible part, it transmits by user and is applied to power on the described control device so that described flexible part bending, wherein, when described control section is operated by described user, described flexible part bends to the configuration of general curved, the form of then getting back to less bending when described control device obtains discharging in a controlled manner from complete straight configuration.

2. equipment according to claim 1 is characterized in that, described tube element is made of rustless steel or marmem (SMA).

3. equipment according to claim 2 is characterized in that described tube element is made of Nitinol.

4. equipment according to claim 1 is characterized in that described recess is set to be arranged in the otch of described flexible part.

5. equipment according to claim 1 is characterized in that, described recess is set to be arranged in the wedge shape grooving of described flexible part.

6. equipment according to claim 1 is characterized in that, described equipment also comprises the adnexa that is blown into that is positioned on the described tube element, comes from the secretions in described patient's the air flue in order to removing and oxygenation is provided.

7. equipment according to claim 1 is characterized in that, the described device that is used for mobile described flexible part is the line that is attached on the described control device.

8. equipment according to claim 1 is characterized in that, described control device is the trigger piece that is installed on the described grip device.

9. equipment according to claim 1, it is characterized in that, described equipment also comprises the display device of the proximal end that is positioned at described equipment, and the far-end reach that is used for described tube element during described endotracheal intubation program the time shows the image of described patient's throat.

10. one kind is inserted the method for patient's trachea with endotracheal tube, comprising:

(a) provide a kind of equipment, it comprises: grip device; Tube element, it has far-end and is attached to near-end on the described grip device; The flexible part of described tube element, it is arranged near the far-end of described tube element, has to be arranged in one or more recesses that described tube element is suitable for making described flexible part bending; Be arranged on the described grip device or near the control device it; And the device that is used for moving described flexible part, it transmits by user and is applied to power on the described control device so that described flexible part bending, wherein, when described control section is operated by described user, described flexible part bends to the configuration of general curved, the form of then getting back to less bending when described control device obtains discharging in a controlled manner from complete straight configuration;

(b) described endotracheal tube is slipped on the tube element of described equipment;

(c) far-end that will have the described tube element of described endotracheal tube inserts in described patient's the mouth;

(d) operate described control device, be enough to make the far-end of described tube element in described patient's throat, to advance safely so that described flexible part bends to;

(e) far-end of described tube element is advanced, described endotracheal tube is placed described patient's trachea; And

(f) described tube element is removed from described patient's mouth.

11. method according to claim 10 is characterized in that, described tube element is made of rustless steel or marmem (SMA).

12. method according to claim 10 is characterized in that, described tube element is made of Nitinol.

13. method according to claim 10 is characterized in that, described recess is set to be arranged in the otch of described flexible part.

14. method according to claim 10 is characterized in that, described recess is set to be arranged in the wedge shape grooving of described flexible part.

15. method according to claim 10 is characterized in that, the described device that is used for mobile described flexible part is the line that is attached on the described control device.

16. method according to claim 10 is characterized in that, described control device is the trigger piece that is installed on the described grip device.

17. method according to claim 16 is characterized in that, described control device is operated by squeezing.

18. one kind is inserted the method for patient's trachea with endotracheal tube, comprising:

(a) provide a kind of equipment, it comprises: grip device; Tube element, it has far-end and is attached to near-end on the described grip device; The flexible part of described tube element, it is arranged near the far-end of described tube element, has to be arranged in one or more recesses that described tube element is suitable for making described flexible part bending; Be arranged on the described grip device or near the control device it; And the device that is used for moving described flexible part, it transmits by user and is applied to power on the described control device so that described flexible part bending, wherein, when described control section is operated by user, described flexible part bends to the configuration of general curved, the form of then getting back to less bending when described control device obtains discharging in a controlled manner from complete straight configuration;

(d) image of the described patient's of observation throat in described display device;

(e) operate described control device, be enough to make the far-end of described tube element in described patient's throat, to advance safely so that described flexible part bends to;

(f) far-end of described tube element is advanced, described endotracheal tube is placed described patient's trachea; And

(g) described tube element is removed from described patient's mouth.

19. method according to claim 18 is characterized in that, described tube element is made of rustless steel or marmem (SMA).

20. method according to claim 19 is characterized in that, described tube element is made of Nitinol.

21. method according to claim 19 is characterized in that, described recess is set to be arranged in the otch of described flexible part.

22. method according to claim 19 is characterized in that, described recess is set to be arranged in the wedge shape grooving of described flexible part.

23. method according to claim 18 is characterized in that, the described device that is used for mobile described flexible part is the line that is attached on the described control device.

24. method according to claim 18 is characterized in that, described control device is the trigger piece that is installed on the described grip device.

25. method according to claim 24 is characterized in that, described control device is operated by squeezing.